Susan Debra Matatia

Primary specialty

CounselorTaxonomy code 101Y00000X

License

1019443 Issued in MA

Practice address

301 Taylor Rd
Stow, MA 01775-1609

Phone

(978) 461-2969

NPI assigned

Sep 11, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthdrive Behavioral Health Services, PLLCGroup PAC ID 8729345822, 89 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Healthdrive Behavioral Health Services, PLLC

  • Geriatric Psychiatry Physician
  • Middletown, CT
  • NPI 1760909279

  MA

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1982187308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 TAYLOR RD",
            "city": "STOW",
            "state": "MA",
            "postal_code": "017751609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 TAYLOR RD",
            "city": "STOW",
            "state": "MA",
            "postal_code": "017751609",
            "telephone_number": "978-461-2969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATATIA",
        "first_name": "SUSAN",
        "middle_name": "DEBRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MA",
            "license": "1019443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Macneill, RPH
• George Mandler, LDN, LICAC
• Margaret Klepacz DDS PC
• Massabni Stow PLLC
• Jennifer London Mast
• Julia Grace McGourty, OTR
• Arthur F Miller, M.D.
• Michelle Lynn Mulroy, LICSW
• Molly B Newman, R.D, L.D.N
• Roxanne Elizabeth Nichols

• Counselor in Stow, MA
• Providers in Stow, MA by specialty
• Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.